Complete Guide to Medicare Special Needs Plans in Santa Clara County, CA
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Welcome to our comprehensive guide to Medicare Special Needs Plans (SNPs) in Santa Clara County, CA for 2025. In this county, there are 20 SNP plans available, each designed to meet specific healthcare needs.
Our guide is here to help you navigate the choices and make the right selection.
Compare Medicare SNP Plans in Santa Clara County, CA
Below is a list of the 20 Medicare Special Needs Plans (SNPs) available in Santa Clara County, CA for 2025. Click on any plan to view full details, including eligibility, coverage, and costs, to find the best fit for your healthcare needs.
Santa Clara County, California Medicare SNP Plans
| Plan Name | Type | Premium | Network | Part D Deduct. |
Rating |
|---|---|---|---|---|---|
| SCAN Balance | C-SNP | $0 | HMO | $0 | |
| SCAN Strive | C-SNP | $26 | HMO | $590 | |
| Alignment Health BreathEasy | C-SNP | $18 | HMO | $590 | |
| Alignment Health Clarity | C-SNP | $24 | HMO | $590 | |
| Alignment Health Heart & Diabetes | C-SNP | $0 | HMO | $0 | |
| Alignment Health Heart & Diabetes CalPlus | C-SNP | $30 | HMO | $590 | |
| Alignment Health Heart & Diabetes Care | C-SNP | $0 | HMO | $0 | |
| Alignment Health Silicon | C-SNP | $30 | HMO | $590 | |
| Imperial Senior Value | C-SNP | $0 | HMO | $0 | |
| Santa Clara Family Health Plan DualConnect | D-SNP | $0 | HMO | $590 | |
| Central Health Dual Access Plan | D-SNP | $0 | HMO | $590 | |
| Central Health Embrace Care Plan | C-SNP | $0 | HMO | $0 | |
| Central Health Embrace Choice Plan | C-SNP | $13 | HMO | $590 | |
| Central Health Focus Plan | C-SNP | $0 | HMO | $0 | |
| Anthem Dual Advantage | D-SNP | $24 | HMO | $590 | |
| Anthem Full Dual Advantage Aligned | D-SNP | $0 | HMO | $590 | |
| Kaiser Permanente Dual Complete North P2 | D-SNP | $0 | HMO | $0 | |
| Premier Care | I-SNP | $0 | HMO | $0 | |
| Senior Care | I-SNP | $30 | HMO | $590 |
Understanding Medicare SNPs
Special Needs Plans (SNPs) under Medicare are designed to provide specialized coverage for individuals with unique healthcare needs. These plans offer benefits and services that are specifically aligned with the health challenges faced by their members.
There are three primary types of SNPs, each designed for a particular group of beneficiaries:
- Dual Eligible SNPs (D-SNPs): D-SNPs are intended for individuals who are eligible for both Medicare and Medicaid, providing coordinated care and additional support services. We have written a complete guide to the meaning and purpose of D-SNP plans to assist you.
- Chronic Condition SNPs (C-SNPs): Targeted at individuals with chronic health conditions, C-SNPs provide specialized care and benefits designed to manage and treat these ongoing conditions.
- Institutional SNPs (I-SNPs): I-SNPs are tailored for individuals residing in long-term care facilities or requiring in-home nursing care, focusing on providing coordinated and specialized care.
Medicare SNP Eligibility Criteria in Santa Clara County
To enroll in an SNP, you must meet certain criteria related to your health or eligibility status. Discover what it takes to qualify for a Special Needs Plan.
Read: Understanding Medicare Special Needs Plans
Why Choose a Medicare SNP?
The specialized benefits offered by Medicare SNPs are tailored to meet the specific healthcare needs of individuals, providing additional services that help manage their conditions more effectively.
- Dual Eligible SNPs: D-SNPs coordinate care between Medicare and Medicaid, offering extra services such as transportation, care management, and/or assistance with daily living. These plans typically include comprehensive drug coverage with minimal copays.
- Chronic Condition SNPs: C-SNPs provide focused care management for chronic conditions like COPD or heart disease, offering tailored treatment plans and easier access to specialized care providers.
- Institutional SNPs: I-SNPs are designed to provide seamless care across nursing homes or in-home care settings, offering personalized health services like therapy and checkups, and possibly support for caregivers.
How to Choose the Best SNP for You in Santa Clara County, CA
Finding the right SNP for you can make a big difference in how well your healthcare needs are met. It’s essential to carefully compare your options to find a plan that suits your health and lifestyle. Just be aware that all types of SNP plan may not be available in Santa Clara County, CA.
- Consider Your Medical Needs: Assess your current health status and any special medical needs you may have. This will help you determine which type of SNP—D-SNP, C-SNP, or I-SNP—will best serve your needs.
- Examine Plan Benefits: Take a close look at the benefits provided by each SNP, including drug coverage, access to specialists, and other essential services. Select a plan that covers the healthcare services you rely on most.
- Check the Network: Make sure that your current doctors, specialists, and hospitals in the Santa Clara County area are part of the plan’s provider network. This ensures continuity of care and access to the providers you trust.
Enrolling in a Medicare Special Needs Plan
Enrolling in the right Medicare SNP for you is essential to accessing the healthcare services you need. Knowing when and how to enroll can help you make the most of your Medicare benefits.
Medicare offers several enrollment periods each year, allowing beneficiaries to join or switch SNPs:
- Initial Enrollment Period (IEP): This is your first chance to enroll in Medicare and an SNP, lasting for seven months around your 65th birthday.
- Annual Enrollment Period (AEP): During the AEP, which runs from October 15 to December 7, Medicare Enrollees can join or switch SNPs for the coming year.
- Special Enrollment Periods (SEPs): If you experience certain life changes, such as a move or loss of coverage, you may qualify for an SEP to change your Medicare plan outside of the regular periods.
For more details on when to enroll, check out our detailed article on Medicare Advantage enrollment periods.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Citations & References
- CMS.gov, 2024 SNP Landscape Source Files, Last Accessed October 14, 2023
- Medicare.gov, "Special Needs Plans (SNP)", Last Accessed September 11, 2023
- CMS.gov, "Institutional Special Needs Plans (I-SNPs)", Last Accessed September 11, 2023
- Medicare.gov, "Your health plan options", Last Accessed May 17, 2023